Evaluation of Closed-System Transfer Devices in Reducing Surface Contamination With Antineoplastic Drugs in Two Patient Administration Areas.

BACKGROUND

Antineoplastic drugs (ADs) are widely used in healthcare settings and dangerous to healthcare workers who may be exposed. Closed-system transfer devices (CSTDs) are engineering controls designed to reduce environmental exposure to ADs.

OBJECTIVES

This study documents AD residue on surfaces in a high-volume outpatient infusion clinic and an inpatient oncology unit before and after the implementation of CSTDs to determine whether this engineering control decreased contamination with ADs.

METHODS

The authors collected 60 surface wipe samples pre- and postimplementation in each setting to assess the detection of etoposide and cyclophosphamide. The authors also conducted semistructured interviews with nurse managers and observed environmental services workers to evaluate training and cleaning practices, respectively.

FINDINGS: This study did not find a significant difference between contamination for either drug in either clinical setting after the implementation of CSTDs. Implications for nursing practice include standardizing appropriate cleaning products and protocols, assigning specific cleaning tasks to nursing, and ensuring that institutional policies for safe handling of ADs are followed.